Are Flat-Footed Runners Prone to Injury?

Runners with flat feet are at the same injury risk as other runners.

Apparently I have flat feet, at least that is what everyone tells me, I always thought the slight curve at the bottom of my foot was an arch but I have to admit, the 'wet' test proves my feet are flat. Are there any running injuries that are more prone to people with flat feet?

A flat foot used to get you classified as 4-F and out of the armed services draft based on the long held opinion that flat feet caused injuries during training and physical activity. Someone finally got around to studying the issue in the military and found that flat feet did not contribute to increased foot injury nor did the flat-footed recruit miss more days of training. I ran cross country and track in the 60’s with a kid with the flattest feet I can remember (behind him at any distance over 400 meters). He was never injured and is still running today.

There are two basic types of flat feet – mobile and rigid. The mobile flat foot forms an arch with toe standing and the rigid foot stays in its usual flat position with the same toe standing maneuver. The rigid flat foot does not absorb shock as well as the foot with a “normal” arch, and the loss of shock absorption is considered a risk by some. So a flat foot may benefit from a shoe that has some built in energy absorbing qualities.

As far as injury, I think the flat-footed runner is subject to the same injuries as the rest of us. However, in a study by Cowan (1993), 20 percent of subjects with the flattest feet had the lowest injury risk and the relative risk for any musculoskeletal injury was increased threefold for the middle arch (60 percent) group and six fold for the high arch (20 percent) group. Although this may not translate directly to runners, the flattest feet may carry the least risk for all injury. The key to avoiding injury from my perspective is staying within the tissue tolerance and gradually increasing activity to toughen the tissues that may be at risk. Runners with mobile flat feet may have more pronation with each foot strike, but for most that is not a problem. Some with mobile flat feet may require some arch support, but I see runners with both mobile and rigid flat feet who do well in minimalist shoes, so everyone is different.

At the end of the day, it sounds like you have flat feet; my recommendation for you is to keep running, have fun, and realize that you are not alone.

I hope this helps.

Cheers,

Bill

Have a question for the Sports Doc? Email him at [email protected] NOTE: Due to the volume of mail, we regret that Dr. Roberts cannot answer every email.

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